Towards establishing clinical guidelines for an arm rehabilitation virtual reality system

Virtual reality (VR) can promote functional rehabilitation of arm movements through environments allowing the practice of a variety of tasks while providing feedback. We evaluated an affordable VR system for arm rehabilitation, developed by Jintronix Inc, based on the Microsoft Kinect and providing three unilateral and two bilateral activities, each with ten difficulty levels. Our objectives were to 1) determine which activities and levels of difficulty are appropriate for rehabilitation of arm movements in stroke patients with different degrees of motor impairment; and 2) determine the ease of use and subjective experience of patients using the VR arm rehabilitation system. Stroke patients participated in three 20-minute practice sessions supervised by a rehabilitation professional. We determined the highest level of difficulty attained by patients in each activity with a performance score of at least 50% and mapped these to arm impairment level according to the Chedoke-McMaster Arm Scale. Over 80% of the participants provided positive feedback in terms of ease of use and VR experience. Our data demonstrate the feasibility of using an affordable VR arm rehabilitation system in a clinical setting and provide clinical guidelines for the selection of impairment-specific difficulty levels.